Such et al reported a prognostic score that is specific for chronic myelomonocytic leukemia (CMML). The authors are from multiple institutions in Spain and Germany.
Patient selection: chronic myelomonocytic leukemia (CMML)
Parameters:
(1) WHO subtype (CMML-1 or CMML-2)
(2) FAB subtype of CMML based on the WBC count (myelodysplastic or myeloproliferative)
(3) cytogenetic risk level of Such et al
(4) RBC transfusion dependency (>= 1 RBC transfusion every 8 weeks for > 4 months)
Findings
CMML-1
CMML-2
blasts and promyelocytes in peripheral blood
< 5%
5-19%
blasts and promyelocytes in bone marrow
< 10%
10-19%
Auer rods
none
any (irrespective of blast count)
where:
• Blast and promyelocyte counts >= 20% indicate acute leukemia.
Parameter
Finding
Points
WHO subtype
0
1
FAB subtype
CMML-MD (WBC count < 13 * 10^9/L)
CMML-MP (WBC count >= 13 * 10^9/L)
cytogenetic risk
low
intermediate
high
2
RBC transfusion dependency
no
yes
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
Score
Risk Group
Median Overall Survival
72 months
intermediate-1
31 months
2 or 3
intermediate-2
13 months
4 or 5
5 months
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Specialty: Hematology Oncology
